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Once a month, my wife and I have a cleaning service that comes to clean my apartment. A small team of women always show up bright and early in the morning to give our apartment a deep scrub.

Usually, either my wife or myself will work from home on that day so that we can be there while they clean. On this day, I was staying home.

When the cleaners arrive, I always ask them to clean my office first so that I can do my work there while they clean the remainder of the home.

This day started the exact same way.

Since I had a few minutes before the office would be ready, I decided to turn on my PlayStation and play some video games while I waited.

Well, one thing led to another and I ended up playing video games for four or five hours.

When I finally finished playing, I was beating myself up for letting the work day get away from me.

I like to think of myself as a hard working entrepreneur and I was feeling embarrassed and ashamed of myself for not living up to my expectation.

Like we all do in these situations, I made a sweeping declaration, “Starting tomorrow, I’m NEVER going to do that again.”

I resolved that “I’m going to wake up at 6am and be on the treadmill by six-thirty! Tomorrow I will be productive!”

Tomorrow came and I followed the plan.

I jumped right out of bed at six and was on the treadmill by six-thirty.

After my workout, I went back to my home office, opened my notebook and was about to begin planning my day. But as I went to put pen to paper, I realized that I couldn’t see.

My vision was blurry.

“Oh no!” I thought.

This was not the first time this had happened. It always happened the same way.

At first, my vision would get blurry. I could see fine in my peripheral vision, but whatever I was trying to focus on would be blurry. There would often be little squiggly lines in my visual field as well.

This would always persist for around thirty minutes before fading away and opening the door for the all-time biggest migraine headache.

Each time this had happened previously, the headache became so painful that I was incapacitated. It would become so painful that I wouldn’t even be able to fall asleep. Any medication was absolutely useless.

This terrified me.

Not only was I afraid of the pain that was to come but it was also a Wednesday. I had a full list of clients scheduled for that day and I was afraid I was going to have to cancel their appointments.

A few weeks prior, I had read a book called Healing Back Pain by Dr. John Sarno. Sarno grew famous for his unique approach to back pain. He believed that the brain often created pain as a way of distracting you from confronting uncomfortable emotions.

He claimed to have cured some of the most difficult chronic back pain conditions simply by educating his clients on this philosophy. In fact, a quick Google search will show you that he has developed quite the tribe of believers online.

We all grasp the concept of the mind-body connection but he was really putting it into practice.

For over a decade prior to this day, I had been studying the brain like crazy. I was convinced that it held some sort of master key to the body.

In fact, there had been several clients right around this time that I had suspected that their pain was not going away because of some sort of neurological block. This is what led me to read Sarno’s book in the first place. I was trying to find a way to help these clients.

At the end of his famous book, he mentions that his theory is not isolated to just back pain. He goes on to list other ailments that could pop up as a result of this neurological anomaly. He even mentioned ocular migraines as one of the possibilities.

“Ok,” I thought to myself, “What would Sarno have me do?”

If the brain was really creating this pain as a way of distracting myself from confronting uncomfortable emotions, what emotion might I be trying to avoid.

The answer, in this case, was obvious. Shame and embarrassment. I had orchestrated this new morning routine as an overcompensation for me playing video games four five hours the previous day.

If my brain was creating the pain from distracting me from confronting that shame and embarrassment, then the answer must be for me to confront them.

So, I closed my eyes and I let those emotions wash over me. I tried to sit in that feeling.

And after a few minutes, guess what happened.

Absolutely nothing.

The pain was still there. If anything, it was getting worse.

My fear began to grow, “Should I cancel my appointments for the day and just go lay in bed.”

Then a thought came into my head…

“If you’re going to teach this stuff to your clients,” I began, “You’ve got to go all the way.”

“You have to go to work.”

If Sarno’s theory was correct, that meant my pain was just smoke and mirrors. It was a false alarm. ¹

If I completely ignore the pain, not give it any authority over me, in theory, the pain should go away.

I have to go to work.

By this point, the pain was building and nausea was setting in.

I put on my work clothes, grabbed my backpack and some sunglasses and went outside to wait for the bus.

It was August, the sun was baking down on me. When the bus came, there were no seats left so I had to stand.

Grasping the hand rails in the busses center aisle, we jostled our way through the Lincoln Tunnel.

Stop…Start…Gas…Brake

I thought I might throw up in the Lincoln Tunnel

I remember seeing sweat dripping down the hand rail as my palms began to perspire.

I closed my eyes.

When our bus finally pulled into the Port Authority Bus Terminal, I thought taking the subway to my office might be too much for my nausea, so I opted for the forty-five minute walk across town instead.

“Maybe the fresh air would be good for me.”

As soon as I stepped out of the bus terminal, I realized I was in the middle of Times Square. Arguably the worst place on the planet for someone dealing with a horrible migraine.

I decided the subway would be best.

“This could be the best day of your life,” I kept telling myself, “If this theory was true, I will have learned one of the great secrets of medicine.”

I kept pushing forward.

Fifteen minutes later, I arrived at my office with my pain continuing to grow.

By this time, I was only thirty minutes or so away from my first appointment and I was terrified that I may have to run to the bathroom to throw-up during the session.

But I kept reminding myself, if the pain is trying to get me to cancel my appointments, if I confront it and prove that I won’t listen to it, then the pain should go away.

The clock kept ticking closer and closer to my first session.

“I can still cancel,” I kept reminding myself, “No! Go all the way through.”

11am finally arrived and my client walked through the door. My pain was at an all time high.

“Hey Sean!” she said, “How are ya?!”

“Great!” I lied as my head was pounding.

With all my effort, I instructed her on her first exercise and as she got down into position and began, it was as if someone had stuck a needle in my head and slowly began deflating the pressure.

It took about an hour but, just like that, the pain had completely gone away.

I had forced my way behind the curtain to find nothing on the other side.

Sarno’s theory was true after all.

“The lower back is the prison and the emotions are the prisoners. At some point the prisoners are going to start a fight.”

That was all I knew about John Sarno prior to 2024. I had come across his work as merely a footnote in my studies over the years but never bothered to look any further.

But by the time I had experienced Sarno’s success for myself, his work was beginning to pop up more and more.

Earlier in the year I was on a video call with a clinic in Colorado who told me that they give a copy of Healing Back Pain to every one of their clients on their first day.

“A huge percentage of symptoms are wiped out just by reading this book,” he told me.

That was surprising to me.

Even as an avid brain researcher, it was tough for me to connect with a woo-woo sounding philosophy.

Then, in the winter of 2023, another client finished my entire 4-month program without getting any relief from his neck pain. Session after session I would throw the kitchen sink at this guy. I tried every exercise I could conceive of but nothing worked.

“Any relief?” I would ask after each exercise.

He would always stand up, move around a little and inevitably reply, “No.”

But I couldn’t shake the feeling that there was more to the story. I don’t know how to explain it but I could see it in his eyes. There was something else there.

When his program ended, I decided to throw up a Hail Mary. I started telling him a little about Sarno’s philosophy just to see if anything stuck.

He burst into tears.

He went on to tell me how he had been doubted his entire life and he just wanted to prove the doubters wrong.

I recommended he read the book.

Two weeks later, he reported 60% symptom relief.

One month later, he was joining basketball and soccer leagues.

I started trying this with some of our other clients struggling to get relief and people were experiencing spontaneous and instantaneous symptom relief.

“I feel like someone is actually seeing me for the first time,” one woman told me.

I even mentioned Sarno’s book in an assessment one time to a woman who came in with chronic shoulder pain. Two weeks later, I received this email.

I was initially very nervous to bring these theories to my clients. I was essentially saying that the pain was all in your head. These people had real pain that was having a real impact on their life. I felt that theory, albeit possibly true, might come off as disrespectful.

But as these staggering results started to populate my client list, I felt a responsibility to push through my nerves and bring this approach to our clients.

Sarno argued that the vast majority of chronic pain, particularly back, neck, and shoulder pain has no structural cause. Rather, it is generated by the brain as a distraction mechanism to prevent emotionally threatening feelings from entering conscious awareness. He called this Tension Myoneural Syndrome (later renamed The Mindbody Syndrome) or TMS for short.

The mechanism he proposed: the autonomic nervous system mildly restricts blood flow (and thus oxygen) to specific muscles, nerves, or tendons, producing real, sometimes severe pain, but pain that serves a psychological purpose.

The Unconscious as the Driver
For Sarno, the brain doesn't generate pain randomly. It does so to keep intolerable unconscious emotions out of consciousness. The inner child (his term) accumulates enormous reservoirs of emotion: from unmet needs, perfectionist self-demands, people-pleasing, suppressed resentment. The conscious mind finds these feelings unacceptable, so the brain provides a more socially acceptable preoccupation: physical pain.

The implications are significant. The pain is real, not faked. It's just caused neurologically rather than structurally.'

The Personality Profile
Sarno described a classic TMS personality: conscientious, perfectionistic, self-critical, high-achieving, people-pleasing, and carrying enormous internal pressure. These people tend to put enormous demands on themselves while also harboring deep, unexpressed resentment about those demands. Sound familiar?

The Treatment: Knowledge as the Cure
This is the most radical and interesting part. Sarno believed that understanding the mechanism is the cure. Once the conscious mind accepts that the pain is psychogenic, the brain's strategy is exposed and rendered unnecessary. The pain loses its purpose. Many of his patients recovered simply by reading his books. No therapy, no exercise, no surgery.

His protocol involved:

The Broader Cultural Critique
Sarno was deeply critical of the medical establishment for what he saw as epidemic overdiagnosis, attributing normal anatomical variations (disc bulges, stenosis, scoliosis) as causes of pain they aren't actually causing. He felt the MRI in particular had unleashed a diagnostic nightmare, giving people structural "explanations" that condemned them to chronic suffering and unnecessary surgery. ²

Legacy and Relevance
Sarno's work has been substantially validated by modern pain neuroscience. Figures like Lorimer Moseley and David Butler have built an entire field ("explain pain") around the brain's role in generating and sustaining chronic pain. The term now used is often nociplastic pain (pain without tissue damage). The predictive processing model of the brain which sees pain as a construction, not a readout, aligns remarkably well with what Sarno was describing clinically decades earlier.

I began studying the brain years ago as a way of unlocking athletic performance. I was curious as to why some people could perform well in practice but they would freeze up during games.

I felt that my job as a performance coach meant improving all of the various aspects of the physical body that contributed to athletic performance and obviously, something in the brain was very influential.

In sport, it’s not hard to see. A pitcher standing on a mound in front of 50,000 people, all-of-a-sudden can’t throw a strike. He’s nervous.

But in chronic pain, it’s less obvious. Often completely hidden from the untrained eye.

What has become clear after 15 years of brain study is that the brain is the gatekeeper to pain. It acts as a, sort of, emergency brake to your body.

Have you ever been driving in your car and noticed that something was off? It wasn’t driving the same way that it usually does. Only to notice a few minutes later that the emergency brake was still on and once you release it, all of a sudden the car runs normally again.

This is exactly how your brain governs your body.

When danger or threat is perceived in your environment, it slams the neurological emergency brake. It’s trying to protect you.

This fight-or-flight reaction has a physical response. The ribs flare. The pelvis tilts forward. The spine extends. Your peripheral vision is closed off and unnecessary functions of the body quiet down in favor of only what is necessary.

As far as your body is concerned, it is experiencing an emergency.

For people who have been in pain for years, this switch never shuts off. Nor does the alarm (pain). They are perpetually in emergency mode.

Dr. Sarno’s philosophy is his way of getting the body out of fight-or-flight and back into rest-and-digest (parasympathetic activation).

Clinically, the brain continues to show up as a major driver of symptoms at Saint Bartholomew. Most people who come to our clinic have similar test results. People in significant pain do not produce significantly worse results than those experiencing minor pain symptoms. What does vary wildly are the symptoms.

We have people diagnosed with a simple ribcage imbalance who have a little back pain and we have people with the exact same ribcage imbalance who have “suicide headaches” (cluster headaches).

If it’s not posture…
If it’s not breathing…
If it’s not strength…
If it’s not metabolic conditioning…
If they’ve exhausted traditional medicine, had all the scans, seen all the specialists and no one can find a thing…

…there’s only one area left. The brain.

All of these experiences forced us to create a Central Nervous System assessment component of our initial evaluation so that we could get a window into how their brain perceives the world. The data we have collected through this assessment has been invaluable.

The brain has proven to be such a major influence on the physical body, that we named our clinic after it.

In 68 AD, Saint Bartholomew was killed in India while on a mission trip. In all of his depictions, he is seen holding his own skin. That’s because, that’s how he was killed. He was flayed alive.

Saint Bartholomew has since been dubbed the Patron Saint of Nervous System disorders because he is representative of shedding the false external layers to reveal who you truly are underneath.

Time after time, we have seen how THAT is the chronic pain cure that traditional medicine couldn’t find.

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